The importance of role and setting in health system social determinants of health screening results

Document Type

Conference Proceeding

Publication Date

4-6-2025

Publication Title

Health Serv Res

Abstract

Background: With recent regulations requiring health systems to conduct social determinants of health (SDOH) screening among patients, more information is needed on best practices to conduct screening. Objective: Analyze differences in SDOH screening rates by screener role and setting at Henry Ford Health based in Detroit, Michigan. Methods: A report of 2023 SDOH screening data was generated and analyzed. Informational interviews and participant observation were also conducted with Medical Assistants (MAs) and Community Health Workers (CHWs). Results: In 2023, 1,066,651 SDOH screenings were conductedby a total of 240 unique job titles. MAs conducted the majority (50.7%) of screenings; however, they identified a low percentage of needs (4.3%). Patient self-reported screens via MyChart comprised 34.8% of screens with 15.6% identifying a need. Conversely, Ambulatory Case Managers (ACM), CHWs, and Mobile Integrated Health (MIH) paramedics conducted far fewer screens, but identified needs in over 70% of screens. Shadowing revealed CHWs used a more conversational approach than MAs. Conclusion: Roles and setting clearly impact SDOH screening. Roles that traditionally better establish trust with patients (i.e., CHW, ACM) are well placed to obtain honest answers regarding needs; however, staffing resources are limited. Empathic inquiry training would benefit MAs to obtain more accurate screens. Patients are also more likely to reveal needs when they are in acomfortable setting (MIH screens occur in patients' homes) or they self-report via MyChart; however, inequities in digital access and technology literacy must be addressed.

Volume

60

Issue

S1

Find It @ Sladen

Share

COinS